PAGE 1

The 4th SEIN Course on Clinical Epileptology was held from 9-20

September 2013.

Although Autumn had seemed to make its early entrance, the students

received a warm welcome from SEIN. On Sunday evening, 8 September,

a small, informal welcome reception was organised at the hotel where

they were staying to break the ice and to give the students the

opportunity to meet course organisers and fellow course participants.

The course lasted 2 weeks (10 working days), with 9 days at SEIN –

Epilepsy Institute in the Netherlands in Heemstede and 1 day at the Free

University in Amsterdam After these intense weeks the participants

returned to their own countries, tired but fulfilled. The students found the

course to be of great use and exhilarating.

SEIN is a tertiary epilepsy centre in the Netherlands which was founded

in 1882 and provides specialised multi-disciplinary care to people with

complex forms of epilepsy. The mission of SEIN is to improve the quality of

life of people with epilepsy worldwide. This course aims to contribute to

this mission.

The students have gained a great deal of knowledge during their stay at

SEIN and they have now taken this knowledge home to apply this in their

own clinical settings, as well as to share with their colleagues.

4th Course on Clinical Epileptology Content

1 4th Course on Clinical Epileptology

2 Participants

2 Speakers

2 Programme

3 Accreditation

3 Session: Epilepsy Care in Students’

own countries

4 Assessment

4 Grants

5 Evaluation

5 Group outing

5 Acknowledgements

Report: 4th SEIN Course on Clinical Epileptology 2013

OCTOBER 2013

Class of 2013

(with course organisers and international speakers)

This 2-week Course in Clinical

Epileptology is intended for young

doctors and fellows from resource-

poor countries.

It is hoped that this will contribute

in some way to the reduction of

the treatment gap in many low

and middle-income countries by

offering young doctors with an

interest in neurology, and

specifically in epilepsy, the

opportunity to follow a short,

extensive and practically oriented

course in epileptology.

The course is organised by

Stichting Epilepsie Instellingen

Nederland/ Epilepsy Institute in the

Netherlands (SEIN).

The organising committee

consisted of Ley Sander, Gerhard

Visser, Hanneke de Boer and

Caroline Morton.

November 2013

PAGE 2

Programme

A number of renowned speakers were able to contribute their expertise

and time to the programme. In total 28 national and 4 international

speakers participated.

Speakers

This year’s programme was grouped around the following themes:

• Classification & Epidemiology and Prognosis

• Diagnosis & Differential Diagnosis in Adults

• Clinical Neurophysiology in Epilepsy and Syncope

• EEG contribution to Epilepsy Classification & Pre-Surgical Workup

• Imaging & Diagnostic Tools in Epilepsy

• Epilepsy Surgery

• Genetics & Epilepsy

• Epilepsy Care: Experiences & Sharing Knowledge

• Pharmacology & AED Treatment

• Epilepsy in Children

• Internet as an Information Tool

• Educational Issues

• How to Present Scientific Data

• International Affairs and Remote Area’s

The programme consisted of didactic sessions, interactive group

discussions, workshops and site visits.

Social activities included a welcome reception on the evening prior to

the start of the course, a group outing (see page 5 for more details) and

a closing dinner.

A new topic was added to this year’s programme: Epilepsy Care in

Student’s Own Countries. This was an interactive session inserted into the

programme to stimulate the students to think about epilepsy care in

their own settings, and how they could improve this. More details on this

session are found on page 3.

At the end of each day there were feedback sessions during which the

students could discuss the topics that were covered during that day or

any other issues which came up.

The course also ended with a light-hearted multiple-choice quiz entitled

“Who wants to be an epileptologist?”. Three prizes were awarded to the

students with the highest scores:

1st prize: Rui Loureiro, Portugal (video camera)

2nd prize: Leyla Baysal, Turkey (MP4 player)

3rd prize: Foster Osei-Poku, Ghana (memory stick).

“The course gives the

students the opportunity

to be interactive and get

involved in activities,

which makes us more

motivated”.

(comment from a student)

Rui (left) & Leyla (below) Rui (left) & Leyla (below)

Foster (left)

Participants

This year’s participants came from Europe (Albania, Bosnia &

Herzegovina, Georgia, Montenegro, Portugal, Turkey), Africa (D.R.

Congo, Ghana and Namibia), South East Asia (Indonesia, Myanmar)

and the Western Pacific (China). A total of 16 young doctors

participated in the course, with varied medical backgrounds, but all with

a common interest in epilepsy.

A number of Dutch fellows currently working at SEIN also participated in

the course, either in full, or for selected topics. One of the Dutch students

commented that she felt it was a highly informative course in which all

aspects of epilepsy were presented in an interactive manner. Besides

this, it was also a unique experience to hear from the participants what

the (social) consequences are for people with epilepsy in other

countries.

“In one word:

Brilliant!”

(comment from a student)

PAGE 3

Group work

EACCME Accreditation The course has been granted 52 European CME credits (ECMEC) by

the European Accreditation Council for Continuing Medical

Education (EACCME). The highest number of credits given thus far

for the course since it was set up 4 years ago.

All participants have received a certificate of accreditation which

will allow them to validate these credits in their own countries.

“Excellent lectures,

wonderful professors”.

(comment from a student)

“I would have to say that

this is a unique approach to

worldwide knowledge of

epilepsy”.

(comment from a student)

The African group in discussion

Epilepsy Care in Student’s own countries The aim of this session was to allow the students to share their

experiences with epilepsy care, each in their own countries and

regions. The students were asked to answer 7 questions on epilepsy

care in their own countries prior to this session:

1. Which anti-epileptic drugs (AED’s) are available in your

country?

2. Are these AED’s easily accessible for people with epilepsy

(how are they prescribed)?

3. Are these anti-epileptic drugs affordable for people with

epilepsy (what do they cost)?

4. Is epilepsy surgery available?

5. Describe the organization of epilepsy care in your country.

6. How much time do doctors spend with patients, per

consultation (on average)?

7. Do you see patients with epilepsy yourself? If so, how often?

The replies were then presented to serve as a basis for discussions and

to trigger the students to think about what could be done to improve

the state of epilepsy care in their own countries.

The students were split into three groups: Africa, Asia and Europe. Each

group was asked to present a proposal for an epilepsy programme for

the countries in these respective regions.

All three groups proposed similar programmes which focus on:

• Identifying problems.

• Raising awareness (patient, public & professional education).

• Reaching key people in the community.

• Securing availability, accessibility and affordability of AED’s.

• Promoting professional education.

• Fostering regional cooperation to refer patients to countries

where certain facilities are available.

what is lacking:

• Adequate epilepsy services.

• Knowledge about epilepsy in the general public.

• Appropriate diagnosis and treatment.

There is a great need for:

• Raising awareness.

• Reducing stigma.

• Placing epilepsy on government’s agenda’s.

Consensus was reached on the following:

• Any improvements in epilepsy care should be incorporated in

the present infrastructure to ensure sustainability.

• Solving problems at the primary health care level will prevent

many problems (this level plays a key role – it is the gateway

through which people with epilepsy enter the health system).

Finally, it was agreed that current activities need to be evaluated

on efficiency and impact, before scaling up is in order.

PAGE 4

Assessment

“Now I am thinking of a

career in epilepsy”.

(comment from a student)

Students in discussion

Grants

Prior to the start of the course the students were asked to complete

the following homework assignments as preparation:

� An essay of 1000 words on one of the following topics:

Dynamics of epilepsy in the population

Impact of epilepsy

Pharmacological diagnosis of epilepsy

Differential diagnosis of epilepsy

� A case-study, which had to be prepared according to a

pre-set format describing:

General and background information

Clinical assessment

Co-morbidities/operations

Drug and social history

Neurological examination

Impression

Hypothesis

The aim of the case study was to learn how to present a case and

encourage discussion among the participants about a possible

diagnosis.

To comply with accreditation requirements, and also to assess the

student’s knowledge at the end of the course, they were given two

written assessments (consisting of 50 multiple choice questions in

total) – one at the end of week 1, the other at the end of week 2.

The total score for the entire assessment was 10 points (5 points for

the written assessments, 2,5 points for the essay and 2,5 points for

the case study). We are delighted to announce that all

participants passed their assessments: the average score was 7.0.

Participants from China, Myanmar

and Turkey enjoying the green

surroundings at SEIN

“The course provided a

perfect balance between

an overview of the most

current in epileptology and

in-depth looks at selected

topics, with emphasis on

application in our own

countries”.

(comment from a student)

The World Health Organization, African Regional Office, funded two

participants from the African Region: DRP Congo and Namibia.

These participants are involved in epilepsy projects in their own

countries and this course was a perfect opportunity to contribute to

capacity building there. Furthmore, participants from Ghana and

Myanmar were partially sponsored through WHO demonstration

projects in their respective countries.

This year we were also able to receive funding from NUFFIC for two

students: one from Bosnia & Herzegovina and one from Myanmar.

The funding covered the costs for their participation, travel and

accommodation. Unfortunately, due to budgetary restrictions due

to the enduring financial crisis, NUFFIC was not able to sponsor more

students.

NUFFIC is the Netherlands organisation for international cooperation

in higher education. As an independent, non-profit organisation

based in The Hague, the Netherlands, NUFFIC supports

internationalisation in higher education, research and professional

education in the Netherlands and abroad, and helps improve

access to higher education worldwide.

Left to right: Amanda Soebadi (Indonesia) and Nazibrola Botchorishvili

(Georgia) receiving their assessment certificates from Prof. Ley Sander

PAGE 5

The organisation of this course would not have been possible

without unrestricted grants from UCB Pharma S.A. Belgium.

SEIN is grateful for their continued support.

The following companies sponsored students to participate:

Newbridge Pharmaceuticals, Dubai, U.A.E.

UCB Trading (Shanghai) Co. Ltd.

UCB Pharma A.S. Turkey

Local support in the Netherlands was also received from:

Ambassador City Centre Hotel, Haarlem

Restaurant De Ark, Haarlem

Brasserie L’Anders, Haarlem

Pannenkoekenrestaurant De Kraai, Zaandam

Jan de Wit Autocars, Haarlem

Twin Catering & Partyservice B.V., Boesingheliede

The course was facilitated through collaboration between SEIN

and the VUmc. In-kind contributions from both institutions were

received, as well as generous support from SEIN. Last but not

least, the course organisers would like to thank all who have

helped to make this course a success. Special thanks go to the

speakers who gave their time and expertise to the programme.

Acknowledgements

Group outing A obligatory group outing was organised halfway during the

course. The participants were taken to an open-air museum

with windmills and typical Dutch craftsmanship (Zaanse Schans).

The day ended with a group dinner. The outing was organised to

give the students a taste of the Netherlands and its culture. It was

a pleasant day, enjoyed by all participants, and was a welcome

break from studying!

Group outing to Dutch open air museum

“The course is a wonderful

opportunity to meet

colleagues from different

countries, to share

experiences and problems

in healthcare for people

with epilepsy in our own

countries”.

(comment from a student)

“A family atmosphere, new

people, different

cultures…but so much in

common”.

(comment from a student)

Participants from Myanmar, China and DRP Congo

with course organisers during group outing

The participants were provided with an evaluation form (at

the end of week 1 and the end of week 2) to rate all aspects

of the course. This survey revealed that the course was

received very positively by the students with high ratings

(mean score):

- course topics (content): 9,48

- speaker skills: 9,39

- course facilities: 9,38

- information material: 8,83

- hotel accommodation: 7,53

- organised leisure activities: 9,81

- transport: 9,41

Under ‘information material’, the hand-outs were not all in a

consistent format and we shall ask the speakers to pay more

attention to this in the future. With regards to the hotel

accommodation, last year students started sharing

accommodation in order to promote group cohesion.

Evaluation, however, shows that 3 people sharing a studio is

too crowded.

Students indicated that they would have liked to have more

case presentation time, a practical workshop on interpreting

EEG’s and more information on status epilepticus. All

comments will be taken into account for the next course.

Reasons for attending the course can be summarised as

follows: “to improve epilepsy care in the student’s home

country”, to “learn from epilepsy experts” and “to learn from

each other”. All students indicated they would recommend

the course to fellow colleagues.

Evaluation